MEDICARE: MOON AND STARS ABA CONSULTING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1649135914
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOON AND STARS ABA CONSULTING LLC

Provider Business Mailing Address
First Line	:	141 PINE TREE LN
Second Line	:
City	:	TAPPAN
State	:	NY
Zip	:	10983-2114
Country	:	US
Telephone Number	:	845-641-8015
Fax Number	:	845-641-8015

Provider Business Practice Location Address
First Line	:	141 PINE TREE LN
Second Line	:
City	:	TAPPAN
State	:	NY
Zip	:	10983-2114
Country	:	US
Telephone Number	:	845-641-8015
Fax Number	:	845-641-8015

Authorized Official
Title or Position	:	OWNER/CLINICAL DIRECTOR
Name	:	CRISSY L WANG
Credential	:	M.S. ED, LBA
Telephone Number	:	845-641-8015

Provider Enumeration Date	:	12/18/2025
Last Update Date	:	12/18/2025

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